Pre-natal exercises for the third trimester

Thank you to my beautiful friend Julia, 38 weeks pregnant, for helping me capture these exercises. 

Thank you to my beautiful friend Julia, 38 weeks pregnant, for helping me capture these exercises. 

I wanted to share this home-based exercise program with mums-to-be in that hope of inspiring a safe and achievable program. All you need is a fit ball/swiss ball, yoga mat and some weights. The program should take around 30 minutes to complete but you can adjust that length depending how many sets of each exercise are completed. 

From my clinical experience these exercises are safe to complete right up until your due date, given that there are no contraindications to participation in exercise. This is determined by the treating Doctor or Obstetrician. These exercises are also safe to try if you are suffering from mild low back pain or pelvic pain, as they don't place any unsafe load on these structures. Each person experiences pregnancy in an individual way, so this program is in no means a 'one size fits all approach'. It is simply a sharing of ideas on some of the exercises that I've used when teaching pre-natal exercise programs. 

Swiss ball pelvic tilting

A great exercise for mobilising and stretching the lower back. Start sitting on the ball with feet placed flat on the floor and hip width apart. Place one hand on your stomach and the other on your lower back. Without moving your upper body, slowly roll the ball backwards by tilting your pelvis forward (known as anterior pelvic tilting) and then roll the ball forward by tilting your pelvis backward (posterior pelvic tilting). 

Repeat 20 times forward and backwards focussing on isolating the movement to the pelvis and lower part of the spine. As your stomach increases in size and weight during pregnancy there are increasing forward loads which pull on the lower back, increasing the amount of 'sway back'. Many exercises to stretch the lower back become awkward, but not this one. Spend as much time rocking forward and back as feels comfortable and right for your body. 

Cat Cow

Begin on your hands and knees with wrists under shoulders and knees under hips, hip width apart. This is known as 4 point kneeling (4PK). Arch your back and begin to look up, aiming for the back to look like a U shaped curve through the entire spine. Then reverse the movement by looking down, tucking your tail bone under and pushing through your arms to arch your spine towards the ceiling. 

Continue to move from the cow to the cat pose at your own comfortable pace. Even pause at the end of each position for one breath in and out. Aim for 20 movements up and down to really stretch the entire spine. 

Tips for correction: the most important part is to try to involve the entire spine. Many people can use either the middle or lower back in each direction but it is challenging to get an even curve. That is what you're aiming for. If your wrists get sore you can balance on closed fists or hold onto weights.

Mermaid stretch

Here we have two versions of the mermaid stretch, a side flexion stretch, that is great for stretching through the side body and opening up space between the ribs. The first is sitting on the ball with feet flat and leaning up and over to the side. The second is with the ball wedged under the hip with the closest leg bent up and the closest elbow resting on the ball. It provides a much stronger stretch down into the side of the chest, stomach and into the thigh. Choose which version feels best for you and perform 10 slow mermaid stretches to each side. 

I really love this exercise because it's a great way to create space in the ribs. Up and over are the words to remember. The two exercises above (pelvic tilting and cat/cow) focus on flexion and extension through the spine while this exercise tackles a different plane of movement. 

Swiss ball rotation or thread the needle

The fourth movement that should be incorporated in this program will focus on spinal flexibility is trunk rotation. This is going to stretch different muscles and joints to side flexion and flexion/extension (seen above). The first exercise on the ball is a pure rotation movement in sitting. Place your arms across your chest and turn to one side the best you can and then turn towards the other. Repeat 10 slow twists in each direction. 

The second exercise also stretches trunk rotation but combined with a shoulder stretch. If you're struggling with tightness in between the shoulder blades or in the thoracic spine, this is a lovely exercises to stretch that out. Start in 4PK and then thread one arm through to the other side. Ideally you can keep twisting until the back of your arm is flat on the floor and your ear resting on the floor (head turns to the same side as the arm is going to). It will depend on how much movement you have and how big the tummy has grown. You can spread your knees wider, keeping the feet together, to make more room as required. Repeat 10 slow threads in each direction or hold the stretch for 10 slow breaths in and out. 

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Arm and leg extensions in 4-point-kneel

This is a great exercise to train both the pelvic floor muscles and lower abdominal muscles. Start in 4PK with wrists under shoulders and knees under hips. Before you begin to move either the arm or leg, first squeeze and lift the pelvic floor muscles and gently draw your belly button to your spine (as though you are hugging your baby with your tummy muscles, but not so hard that you squash it). Then try to maintain your balance with these muscles engaged and extend one arm, one leg, or opposite arm and leg. Return the arm/leg back to the starting position and swap sides. Alternate sides for 45 seconds, then rest (maybe in child's pose if that's available to you) and repeat 3 sets. 

Tips for correction: The goal is to not sway your body from side to side or twist and arch your back. The aim is to maintain neutral spinal alignment and use the shoulder muscles and buttock muscles to move the arm or leg. If you just can't stop yourself from leaning to the side then try line yourself next to a wall and concentrate on not leaning onto it. This at least gives you feedback for correction and will stop you loosing balance. 

Swiss ball bridge

One of the major muscles you need to keep strong during pregnancy is the gluteal muscles - which we can exercise with squats and bridges. During the third trimester it is generally recommended to avoid lying completely flat on your back as this can alter blood flow to the baby. This version of a bridge allows for the hips to stay below the heart (as seen below) while still strengthening the hip muscles. 

Start by sitting on the floor with your neck, head and shoulder on the ball. Place your feet hip width apart and then squeeze your buttock muscles to lift your hips up off the floor. Slowly lower down half way and then return to the top. Repeat at your own comfortable pace for 45 seconds. Take a break for 15 seconds. Repeat three sets. Your butt will be burning by the end. The ball also adds an element of balance to the exercise while still supporting the upper body. 

Swiss ball squats

With the ball comfortably just above the small of your low back and leaning up against a supportive wall, you can squat up and down without overloading the ankles and knees. It is also a great exercise to combine with a pelvic floor contraction. 

The aim is to walk your feet far enough forward that you are leaning into the wall and when you squat down, the knees don't move past the toes. Ideally the shins remain straight and knees stay apart. Drive through the heels and roll the ball back up the wall to return to standing. Repeat at your own comfortable pace for 45 seconds. Rest for 15 seconds. Repeat three sets. 

Swiss ball wall push up

Place the ball against the wall and stand at a full arms length from the ball. The wider you place your hands, the more support you will have. Then bend through the elbows to lower your body towards the wall, trying not to bend just from the hips. Repeat the push ups for 45 seconds. Rest for 15 seconds and repeat three sets. 

Tips for correction: Gently engaging your pelvic floor and drawing your belly button towards your spine to hug your baby. This is a great way to make sure your body stays in a straight line and avoids sagging through the low back. 

You can perform a wide elbow (pec) push up or a narrow elbow (tricep) push up which is shown below. I personally prefer the tricep push up as it places less pressure through the wrists.

If you're looking for an extra challenge in balance, balance on one leg. 

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Swiss ball bicep curl

Sitting on the ball with feet hip width apart and your pelvis in neutral position. This should be half way between the extremes of anterior and posterior pelvic rotation (practised above) and also directly down on your 'sit bones'. Choose the weight you are comfortable with. 

Start by engaging your pelvic floor with a 'squeeze and lift' technique, then lift the weights into a bicep curl (seen below) and lower the weights without lowering the pelvic floor muscles. Depending on your strength and endurance, you can perform 1,3,5.... bicep curls before taking a quick break to reset the pelvic floor muscles. Perform the bicep curl at your own comfortable pace. Aim for three sets of 45 seconds. 

Tips for technique: You don't have to engage your pelvic floor but is a great functional exercise that really challenges these muscles and makes good use of your time.

When lowering the weights down back by your side there can be the tendency to roll through front of the shoulders forward. Make sure the movement just comes from the elbow. Bend to lift the weight. Extend to lower. Nothing to do with the shoulders. 

Swiss ball over head press

Following the same guidelines as for the bicep curl but this exercise is now for the shoulders and involves an overhead press. Sometimes you might need to change weights to adjust for the difficulty of this exercise. Aim for three sets of 45 seconds. 

I hope you enjoyed this program and learning about the best way to go about each exercise. I also hope to share other programs that demonstrate different varieties of exercises.  Feel free to leave comments below.

Good luck, Sian :)